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Pancreatic neuroendocrine microtumors in the elderly: A retrospective study using cadaveric pancreatic tissue
Ting Yang1, Ke Ren2, Xiang-Quan Chen2
1Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo 116-8551, Japan.
Background:
Pancreatic neuroendocrine microtumors (PNEMTs) are small (< 5 mm), non-functioning, well-differentiated neuroendocrine neoplasms. Although they are rare, they are not invariably benign. PNEMTs are typically discovered incidentally during autopsy. However, data regarding the occurrence of PNEMTs in the elderly population, particularly those identified incidentally in cadaveric studies, remain limited.
Aim:
To investigate the prevalence and histopathological characteristics of PNEMTs in elderly individuals by analyzing cadaveric pancreatic tissues.
Methods:
We conducted a retrospective analysis of 85 pancreatic specimens (age range: 58-109 years) obtained from cadavers for anatomical education and research at the Department of Life Dentistry, Nippon Dental University. Paraffin sections of the pancreatic head, body, and tail were prepared for histological and immunohistochemical analysis.
Results:
Five cases with PNEMTs (5/85, 5.9%; male, n = 33; female, n = 52; mean age: 85.8 ± 12.1 years) were identified. The tumors were solitary, well circumscribed, and located within the pancreatic parenchyma (body: n = 4; tail: n = 1), and all were < 5 mm (range: 0.54-2.20 mm) in size. All tumors showed strong chromogranin A and synaptophysin positivity, and were predominantly glucagon (GLU)-positive. Ki-67 immunostaining indicated minimal proliferative activity; therefore, these tumors were considered non-functioning, GLU-producing, well-differentiated grade 1 PNEMTs.
Conclusion:
Small, predominantly low-grade, GLU-secreting PNEMTs were present in 5.9% of elderly individuals, highlighting the prevalence of subclinical PNEMTs and the need for careful follow-up.
Insights
Pancreatic neuroendocrine microtumors (PNEMTs) were found in 5.9% of elderly cadavers. These small, non-functioning tumors were predominantly glucagon-producing, indicating subclinical disease in older populations.
Area of Science:
- Gastroenterology
- Endocrinology
- Pathology
Background:
- Pancreatic neuroendocrine microtumors (PNEMTs) are small, well-differentiated neoplasms.
- While rare, PNEMTs can be malignant and are often found incidentally during autopsy.
- Limited data exist on PNEMT prevalence in the elderly, especially from cadaveric studies.
Purpose of the Study:
- To determine the prevalence and histopathological features of PNEMTs in elderly individuals.
- Analysis of cadaveric pancreatic tissues was employed to achieve this objective.
Main Methods:
- A retrospective analysis of 85 pancreatic specimens from cadavers (aged 58-109 years) was performed.
- Histological and immunohistochemical analyses were conducted on paraffin-embedded pancreatic tissues.
Main Results:
- PNEMTs were identified in 5.9% (5/85) of elderly individuals studied.
- The identified PNEMTs were solitary, small (<5 mm), and predominantly glucagon-positive.
- Tumors exhibited minimal proliferative activity (Ki-67), classifying them as well-differentiated grade 1.
Conclusions:
- Subclinical PNEMTs, primarily low-grade and glucagon-secreting, are present in 5.9% of the elderly population.
- These findings underscore the prevalence of undiagnosed PNEMTs in older individuals.
- Careful follow-up may be warranted for elderly individuals.
